Debate on Paying for Medicare Heats Up



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 While politicians on both sides of the aisle agree that projections of Medicare's soaring costs mean some intervention will have to be implemented, the battle to find a remedy looks to be guided as much by emotion as rational planning. Last week Health and Human Services Secretary Kathleen Sebelius warned that the Republican plan to replace fee-for-service Medicare with a system of vouchers allowing beneficiaries to buy their insurance in the private market raises the risk that America's seniors will run out of their own money and be forced to go without medical care. She even suggested that cancer patients under the Republican plan could "die sooner." She based this on a CBO estimate that that by 2030, seniors will be paying for 68% of their care out of pocket, compared with 25% now. Not surprisingly Republicans reacted with outrage. Also on the Medicare reform agenda is how to pay physicians for their services in the future. For more on that controversy, see http://pn.psychiatryonline.org/content/46/6/4.1.full.